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More on CFS and sleep.

Patients with chronic fatigue syndrome (CFS) present a disordered sleep pattern and frequently undergo polysomnography to exclude a primary sleep disorder. These studies have shown reduced sleep efficiency, a reduction of deep sleep, prolonged sleep initiation, and alpha-wave intrusion during deep sleep. Deregulation of the 2-5A synthetase/RNase L antiviral pathway and a potential acquired channelopathy are also found in a subset of CFS patients and could lead to sleep disturbances. This study compiles a large sleep study database of CFS patients and correlates these data with a limited number of immune parameters because it has been thought that RNase L could be associated with these sleep disturbances. Forty-eight patients fulfilling CDCP criteria for CFS underwent extensive medical evaluation, routine laboratory testing, and a structured psychiatric interview. Subjects then completed a complaint checklist, and a two-night polysomnographic investigation and RNase L analysis was performed. CFS patients experienced a prolonged sleep latency, showed a low sleep efficiency index, and had a low percentage of slow wave sleep. The present alpha into delta sleep intrusion correlated with anxiety; no correlations appeared, however, between alpha-delta sleep and immunologic parameters, including RNase L.


Van Hoof E, De Becker P, Lapp C, et al. Defining the occurrence and influence of alpha-delta sleep in chronic fatigue syndrome. Am I Med Sci. 2007 Feb; 333(2):78-84.

COMMENT: The main findings were validation of sleep latency problems and other sleep disturbances already previously suggested; alpha-delta intrusion appeared to be associated with anxiety, and elevated RNase L did not correlate with alpha-delta sleep intrusion. This introduces one more factor into the mosaic of factors in CFS: that of a not-infrequent association with an immediately prior viral infection. Deregulation of one of the antiviral pathways is the evidence. Again, sleep issues are an integral part of the mosaic. Improving sleep, in my experience, makes life more tolerable for these patients, but does not cure the syndrome.
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Title Annotation:Fibromyalgia and Chronic Fatigue Syndrome; chronic fatigue syndrome
Author:Anderson, Robert A.
Publication:Townsend Letter
Geographic Code:1USA
Date:Feb 1, 2008
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